Elsevier

Survey of Ophthalmology

Volume 40, Issue 2, September–October 1995, Pages 89-118
Survey of Ophthalmology

Major review
Excimer laser photorefractive keratectomy*

https://doi.org/10.1016/S0039-6257(95)80001-8Get rights and content

Abstract

Excimer laser photorefractive keratectomy has been used for the correction of myopia, hyperopia and astigmatism. This laser removes tissue through a process termed photoablative decomposition, in which incident photon energy is sufficient to break molecular bonds. Selective removal of tissue across the anterior corneal surface results in a change in anterior corneal curvature. The surgical outcome may be influenced also by interindividual variability in wound healing and pharmacologic interventions. The nature of the excimer laser-tissue interaction, and clinical outcomes of predictability, stability and complications of surgery for myopia are discussed in detail.

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      Excimer lasers at ultraviolet (UV) wavelengths, which are well-absorbed by collagen, are being used in vision correction surgeries such as laser-assisted in-situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). A typical example of an Excimer laser used in LASIK surgery emits 193 nm wavelength, and works at approximately 20 ns pulse duration, 100–250 mJ/cm2 radiant exposure, with a beam 100 μm in diameter [16]. The dynamic changes in the optical properties of water at 193 nm (ArF excimer) and 2940 nm (Er:YAG) are well established [17–19].

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    *

    Supported in part by an unrestricted grant from Research to Prevent Blindness, Inc., New York, New York. Dr. McDonnell is a William and Mary Greve International Research Scholar.

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